1
QMA Final Practice Test Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Section 1: Medication Administration & Safety
Q1: The QMA is preparing to administer a medication to a resident. To which of the following
should the QMA apply the "Three Checks"?
A. Before removing the medication from the storage area, at the cart, and before leaving the
medication room
B. Before removing the medication from the storage area, at the cart, and before administering
[CORRECT]
C. At the cart, after administering, and at the end of the shift
D. When the prescription is received, when the cart is pulled, and when the nurse signs off on the
MAR
Correct Answer: B
Rationale: The "Three Checks" are standard practice for safe administration. The QMA must
check the medication against the MAR three times: when taking it from storage, when preparing
it, and at the bedside just before giving it to the resident.
Q2: A QMA is about to administer an ophthalmic drop. Which technique is correct?
A. Apply the drop directly to the center of the cornea.
B. Apply the drop into the lower conjunctival sac and apply gentle pressure to the inner canthus
for 1-2 minutes. [CORRECT]
C. Apply the drop to the sclera.
D. Have the resident close their eyes tightly for 5 minutes.
Correct Answer: B
,2
Rationale: Ophthalmic drops should be instilled into the lower conjunctival sac. Applying gentle
pressure to the inner canthus (near the nose) prevents the drop from draining into the
nasolacrimal duct and systemic absorption.
Q3: Which of the following medications is typically outside the standard QMA scope of practice
to administer?
A. Oral solid tablets
B. Sublingual nitroglycerin tablets
C. Subcutaneous insulin [CORRECT]
D. Transdermal fentanyl patches
Correct Answer: C
Rationale: QMAs generally cannot administer injections (subcutaneous, IM, IV). Sublingual
tablets and transdermal patches are typically within the QMA scope if the resident is stable, but
injections require nursing assessment and are generally outside standard QMA duties.
Q4: The QMA is preparing to administer a sublingual tablet. Which instruction is correct?
A. Have the resident swallow the tablet with a sip of water.
B. Have the place the tablet under the tongue and allow it to dissolve completely. [CORRECT]
C. Have the place the tablet between the cheek and gum and chew it.
D. Have the place the tablet on the tongue and immediately swallow it.
Correct Answer: B
Rationale: Sublingual medications are designed to dissolve under the tongue for systemic
absorption. The resident should not chew or swallow them whole, as this alters their intended
absorption.
Q15: A QMA is preparing to apply a transdermal patch. Which instruction is correct?
A. Apply the patch to the patient's lower back.
B. Remove the old patch and immediately apply the new patch to the same site.
C. Remove the old patch, clean the skin, rotate the application site, and avoid hairy/oily areas.
[CORRECT]
,3
D. Cut the patch in half if the prescribed dose is lower than the available strength.
Correct Answer: C
Rationale: Transdermal patches should not be cut, and old patches must be removed before
applying a new one to prevent overlapping and overdose. The skin site should be clean, dry,
intact, and rotated to ensure adequate absorption.
Q16: A prescription reads "Ipratropium nasal spray, 2 sprays per nostril once daily." The QMA
notes the patient has a history of closed-angle glaucoma. What is the correct QMA action?
A. Administer as prescribed, as it will lower intraocular pressure.
B. Do not administer and notify the supervisor. [CORRECT]
C. Administer half the prescribed dose to be safe.
D. Administer the medication but tell the patient to see an ophthalmologist immediately.
Correct Answer: B
Rationale: Ipratropium is an anticholinergic that can worsen narrow-angle glaucoma by further
narrowing the angle. QMAs cannot override a prescription; they must hold the medication and
immediately notify the supervising nurse or pharmacist.
Q17: The QMA is preparing to administer a rectal suppository. How far should the QMA insert
the suppository into the rectum?
A. 0.25 inch
B. 0.5 inch for adults [CORRECT]
C. 1 inch for adults
D. 1.5 inches
Correct Answer: B
Rationale: Standard practice is to insert a rectal suppository approximately 1 to 1.5 inches for
adults (often taught as 0.5 to 1 inch, but the highest safe depth is used for accuracy in many
guidelines). A 0.25-inch insertion may not allow the suppository to be retained properly.
Q18: A QMA is preparing a dose of a crushed medication. Which of the following medications
must NOT be crushed?
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A. Regular metoprolol tablets
B. Morphine immediate-release tablet
C. Metformin extended-release tablets [CORRECT]
D. Acetaminophen regular tablets
Correct Answer: C
Rationale: Extended-release (ER, SR, CR, XL) medications have a coating or matrix system that
destroys their extended-release properties if crushed, which can lead to an overdose.
Q19: Which of the following medications must be stored in a locked, double-locked cabinet?
A. Acetaminophen
B. Albuterol
C. Amphetamine [CORRECT]
D. Loratadine
Correct Answer: C
Rasmationale: Amphetamine is a Schedule II controlled substance. It must be kept in a locked
area, which is typically inside a locked medication cart or cabinet to prevent diversion.
Q20: How often must controlled substances (Schedule II) be counted in a long-term care facility?
A. Weekly
B. Every shift (beginning and end) [CORRECT]
C. Monthly
D. Annually
Correct Answer: B
Rationale: *Regulations require a precise count of controlled substances at the beginning and end
of every shift by two authorized personnel (usually the QMA and an RN).
Q21: A QMA is comparing two medications on the shelf that look very similar due to look-
alike/sound-alike (LASA) confusion. What should the QMA do?
QMA Final Practice Test Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Section 1: Medication Administration & Safety
Q1: The QMA is preparing to administer a medication to a resident. To which of the following
should the QMA apply the "Three Checks"?
A. Before removing the medication from the storage area, at the cart, and before leaving the
medication room
B. Before removing the medication from the storage area, at the cart, and before administering
[CORRECT]
C. At the cart, after administering, and at the end of the shift
D. When the prescription is received, when the cart is pulled, and when the nurse signs off on the
MAR
Correct Answer: B
Rationale: The "Three Checks" are standard practice for safe administration. The QMA must
check the medication against the MAR three times: when taking it from storage, when preparing
it, and at the bedside just before giving it to the resident.
Q2: A QMA is about to administer an ophthalmic drop. Which technique is correct?
A. Apply the drop directly to the center of the cornea.
B. Apply the drop into the lower conjunctival sac and apply gentle pressure to the inner canthus
for 1-2 minutes. [CORRECT]
C. Apply the drop to the sclera.
D. Have the resident close their eyes tightly for 5 minutes.
Correct Answer: B
,2
Rationale: Ophthalmic drops should be instilled into the lower conjunctival sac. Applying gentle
pressure to the inner canthus (near the nose) prevents the drop from draining into the
nasolacrimal duct and systemic absorption.
Q3: Which of the following medications is typically outside the standard QMA scope of practice
to administer?
A. Oral solid tablets
B. Sublingual nitroglycerin tablets
C. Subcutaneous insulin [CORRECT]
D. Transdermal fentanyl patches
Correct Answer: C
Rationale: QMAs generally cannot administer injections (subcutaneous, IM, IV). Sublingual
tablets and transdermal patches are typically within the QMA scope if the resident is stable, but
injections require nursing assessment and are generally outside standard QMA duties.
Q4: The QMA is preparing to administer a sublingual tablet. Which instruction is correct?
A. Have the resident swallow the tablet with a sip of water.
B. Have the place the tablet under the tongue and allow it to dissolve completely. [CORRECT]
C. Have the place the tablet between the cheek and gum and chew it.
D. Have the place the tablet on the tongue and immediately swallow it.
Correct Answer: B
Rationale: Sublingual medications are designed to dissolve under the tongue for systemic
absorption. The resident should not chew or swallow them whole, as this alters their intended
absorption.
Q15: A QMA is preparing to apply a transdermal patch. Which instruction is correct?
A. Apply the patch to the patient's lower back.
B. Remove the old patch and immediately apply the new patch to the same site.
C. Remove the old patch, clean the skin, rotate the application site, and avoid hairy/oily areas.
[CORRECT]
,3
D. Cut the patch in half if the prescribed dose is lower than the available strength.
Correct Answer: C
Rationale: Transdermal patches should not be cut, and old patches must be removed before
applying a new one to prevent overlapping and overdose. The skin site should be clean, dry,
intact, and rotated to ensure adequate absorption.
Q16: A prescription reads "Ipratropium nasal spray, 2 sprays per nostril once daily." The QMA
notes the patient has a history of closed-angle glaucoma. What is the correct QMA action?
A. Administer as prescribed, as it will lower intraocular pressure.
B. Do not administer and notify the supervisor. [CORRECT]
C. Administer half the prescribed dose to be safe.
D. Administer the medication but tell the patient to see an ophthalmologist immediately.
Correct Answer: B
Rationale: Ipratropium is an anticholinergic that can worsen narrow-angle glaucoma by further
narrowing the angle. QMAs cannot override a prescription; they must hold the medication and
immediately notify the supervising nurse or pharmacist.
Q17: The QMA is preparing to administer a rectal suppository. How far should the QMA insert
the suppository into the rectum?
A. 0.25 inch
B. 0.5 inch for adults [CORRECT]
C. 1 inch for adults
D. 1.5 inches
Correct Answer: B
Rationale: Standard practice is to insert a rectal suppository approximately 1 to 1.5 inches for
adults (often taught as 0.5 to 1 inch, but the highest safe depth is used for accuracy in many
guidelines). A 0.25-inch insertion may not allow the suppository to be retained properly.
Q18: A QMA is preparing a dose of a crushed medication. Which of the following medications
must NOT be crushed?
, 4
A. Regular metoprolol tablets
B. Morphine immediate-release tablet
C. Metformin extended-release tablets [CORRECT]
D. Acetaminophen regular tablets
Correct Answer: C
Rationale: Extended-release (ER, SR, CR, XL) medications have a coating or matrix system that
destroys their extended-release properties if crushed, which can lead to an overdose.
Q19: Which of the following medications must be stored in a locked, double-locked cabinet?
A. Acetaminophen
B. Albuterol
C. Amphetamine [CORRECT]
D. Loratadine
Correct Answer: C
Rasmationale: Amphetamine is a Schedule II controlled substance. It must be kept in a locked
area, which is typically inside a locked medication cart or cabinet to prevent diversion.
Q20: How often must controlled substances (Schedule II) be counted in a long-term care facility?
A. Weekly
B. Every shift (beginning and end) [CORRECT]
C. Monthly
D. Annually
Correct Answer: B
Rationale: *Regulations require a precise count of controlled substances at the beginning and end
of every shift by two authorized personnel (usually the QMA and an RN).
Q21: A QMA is comparing two medications on the shelf that look very similar due to look-
alike/sound-alike (LASA) confusion. What should the QMA do?
